title: Thromboelastographic evaluation of dogs with congenital portosystemic shunts.
abstract: BACKGROUND
  On plasma-based assays, dogs with congenital portosystemic shunts (CPSS) have changes in serum concentrations of both pro- and anticoagulant proteins, but how these abnormalities affect whole blood coagulation assays (eg, thromboelastography) are unknown.
  
  
  OBJECTIVE
  To conduct kaolin-activated thromboelastography (TEG) analysis in dogs with CPSS and to compare TEG coagulation status with clinical presentation, routine serum biochemistry, and plasma-based coagulation tests.
  
  
  METHODS
  Twenty-one client-owned dogs with CPSS confirmed by ultrasound examination or nuclear scintigraphy.
  
  
  METHODS
  In a prospective study, signalment, clinical presentation, TEG analysis, CBC, serum biochemistry, and hemostatic tests (platelet count, prothrombin time [PT], activated partial thromboplastin time [aPTT], quantitative fibrinogen, antithrombin [AT] activity, protein C [PC] activity, d-dimers, and factor VIII activity) were analyzed in dogs with CPSS.
  
  
  RESULTS
  Dogs with CPSS had significantly shorter K values and increased angle, maximum amplitude (MA), and G values compared with the reference population. On plasma-based coagulation testing, dogs with CPSS had significantly prolonged PT, lower platelet counts, lower AT and PC activities, and increased d-dimers and factor VIII activity. Evaluation of G value defined 9/21 dogs with CPSS as hypercoagulable. These dogs were more likely to have hepatic encephalopathy (HE) than CPSS dogs that had normal coagulation.
  
  
  CONCLUSIONS
  TEG analysis detected hemostatic abnormalities consistent with a hypercoagulable state in some dogs with CPSS. The presence of a hypercoagulable state was 40 times more likely in dogs with symptomatic HE.
authors.affiliation: Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, Grafton, MA.
authors.forename: D
authors.initials: D
authors.lastname: Kelley
authors.forename: C
authors.initials: C
authors.lastname: Lester
authors.forename: A
authors.initials: A
authors.lastname: DeLaforcade
authors.forename: C R L
authors.initials: CR
authors.lastname: Webster
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000097:blood / Q000151:congenital*; D004285:Dogs; D005260:Female; D008297:Male; D011168:Portal System / Q000002:abnormalities*; D013916:Thrombelastography / Q000662:veterinary*
keywords: Coagulation; Encephalopathy; Hepatic disease